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Trisomy 18 의 임신 삼분기별 산전 초음파 소견
서미덕(Mi Deok Seo),원혜성(Hye Sung Won),정지윤(Ji Youn Chung),신혜진(Hye Jin Shin),이종표(Jong Pyo Lee),이필량(Pil Ryang Lee),이인식(In Sik Lee),김암(Ahm Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.9
목적 : Trisomy 18의 임신 삼분기별 초음파 소견을 정리하여 가능한 빠른 산전 진단과 적절한 산과적 상담 및 산과적 처치에 도움이 되고자 하였다.연구방법 : 1993년 3월부터 2000년 1월까지 서울 중앙병원 산부인과에서 초음파 시행하여 Trisomy 18로 진단된 23예를 후향적 조사하여 임신 분기별 초음파 이상소견을 정리하였다. 결과 : 임신 제 1삼분기에는 2예, 2삼분기에 11예, 3삼분기에는 10예의 분포를 보였다.임신 삼분기별 초음파 소견으로는, 1삼분기에는 increased nuchal translucency (>3mm)가 있었다. 임신 2삼분기에는 맥락총 낭포 (100%), 사지 기형 (100%), 선천성 심장 기형 (82%), 소하악증 (45%), 자궁내 성장 지연 (45%), strawberry shaped skull (45%)순으로 많았다. 임신 3삼분기에는 자궁내 성장 지연 (90%), 선천성 심장 기형 (50%), clenched hands with overlapping fingers (50%), 양수과다증 (40%), 소하악증 (40%), 소뇌연수조의 증대 (30%)순으로 저명하였다. 그 외에도 제대류, 선천성 횡격막 탈장증, 식도 폐쇄증, 낭포성 수종, 단일 제대동맥이 있었다.결론 : 본 연구결과를 토대로 임신 삼분기에 따른 특징적인 소견을 정리함으로써 초음파 검사가 가능한 빠른 주수에 Trisomy 18 태아의 정확한 산전 진단 및 유전상담을 하는데 도움을 줄 수 있을 것으로 사료된다. Object : To identify the abnormal sonographic findings of trisomy 18 in relation to trimesters of pregnancy for the antenatal diagnosis of trisomy 18.Material and Method : Prenatal sonographic findings of 23 consecutive trisomy 18 fetuses who were confirmed by chromosomal analysis were collected from march 1993 to January 2000 and reviewed retrospectively.Results : Two fetuses underwent antenatal sonographic examination in the first trimester, 11 fetuses underwent antenatal sonographic examination in the second trimester, and 10 fetuses underwent antenatal sonographic examination in the third trimester. The abnormality found in the first trimester was an increased nuchal translucency (>3mm). The most frequently detected sonographic abnormality in the second trimester was the bilateral choroid plexus cysts (100%). The most frequently detected sonographic abnormality in the third trimester was intrauterine growth restriction (90%). Other sonographic abnormalities detected commonly in second and third trimesters were congenital heart disease, a variety of abnormality in the extremities, micrognathia, strawberry-shaped skull, enlarged cisterna magna, polyhydramnios, and single umbilical artery. The abnormal sonographic findings detected occasionally were omphalocele, diaphragmatic hernia, esophageal atresia, cystic hygroma, and horseshoe kidney.Conclusion : Awareness of these sonographic abnormalities characteristic in trisomy 18 was helpful for us to diagnose this disorder, and was important to provide proper counselling according to the trimester of pregnancy.
생태 시민성 함양과 「고전과 윤리」의 고전 읽기 : 『금강경』을 중심으로
김미덕 ( Kim¸ Mi-deok ),이경무 ( Lee¸ Kyoung-moo ) 한국윤리학회 2021 倫理硏究 Vol.134 No.1
지구는 전체가 하나의 생태공동체이다. ‘생태 시민성’은 인류가 생태공동체 구성원으로서 살아가기 위해 갖추어야 하는 덕성이다. 인류는 환경 문제의 쟁점에 대한 합리적인 결정을 위해, 지속 가능한 인간 공동체와 사회를 만들기 위해 생태 시민으로서 자질과 역량을 국가시민·지구시민·세계시민의 차원 모두에서 갖추어야 한다. 『금강경』은 우리나라에서 가장 널리 유포되고 신봉된 불교 경전의 하나로, 근본 불교의 연기와 무상, 무아 그리고 대승불교의 공 사상을 근간으로 한다. 『금강경』의 내용은 존재하는 모든 것들의 상호 의존성을 전제하는 점에서, 인류가 당면한 지구촌의 생태계 위기를 극복하는 데 필요한 중요한 가르침을 시사한다. 현행 도덕과 교육과정 「고전과 윤리」에 수록된 『금강경』은 ‘타인과의 관계’ 맺음을 중심으로 하는 점에서, 생태공동체의 윤리 문제와는 직접적으로 연계되지 않는다. 따라서『금강경』의 내용을 생태 시민성 역량 함양으로까지 확장하여 다루기 위해서는 생태공동체의 윤리 문제를 도덕과 교육과정 전체와 연계하여 음미할 수 있어야 한다. Environmental and ecological problems are implying not only for a particular country or society but also for a global citizens’ ethics. And the global citizens’ ethics are not for only present ages but also for future generations. Therefore, all kinds of ecological citizenship education should be understood and carried out from the ‘sustainable development’ view points. Therefore, this study examine how the perspective of ‘ecological citizenship’ will be presented and implemented in the content of moral education curriculum aimed at cultivating citizenship in today’s era of global ecological crisis? In particular, we intend to analyze the contents of the ‘Diamond Sutra’ presented in the high school textbook 「Classics and Ethics」. ‘Diamond Sutra’ Classic is not for teaching aimed at citizens living in a particular age or society but able to connecting with that and showing for teachings for all ages and communities of all societies and the world. Therefore, in other to accomplish the exam of this study, it is necessary to clarify 1) the concepts of global civic ethics and ecological citizenship 2) the relationships between ecological citizenship and ‘Diamond Sutra’.
뇌경색 한방치료중 독성간염(약물유인성 간염)으로 추정되는 간기능 손상의 1례
이민수,송미덕,이승희,Lee, Min-Su,Song, Mi-Deok,Lee, Seung-Hi 대한한방내과학회 2000 大韓韓方內科學會誌 Vol.21 No.5
Although there are a few reports concerning the hepatic injury of herbal medicine in western medicine, there is no reports concerning the hepatic injury of herbal medicine in oriental medicine. We experienced one case of the hepatic injury suggested toxic hepatitis (drug induced hepatitis) in the treatment of oriental medicine for cerebral infarction. We make a reports for the progress of treatment. One patient of Rt hemiparesis diagnosed cerebral infarction in Brain MRI was administered Taeumin Yuldahanso-tang, treated with physical therapy and improved in the state of Rt hemiparesis(Gr 2/3,4). In the course of treatment, the patient intermittently complained of general weakness, dizziness, pericephalic discomfort(頭不淸), nausea, both leg weakness so we changed Taeumin Yuldahanso-tang to Soyangin Dokwhaljiwhang-tang. Alter that, the patient complained of general weakness, abdominal discomfort, heat and fever($38.4^{\circ}C$). We recognized the elevated total bilirubin(1.7mg/dl), serum transaminase(AST534U/L ALT720U/L), serum gammg glutamyl transpepridase (GGT106mg/dl) and Alk phosphatase124U/L. In the abdominal ultrasonogram there is hepatomegaly (16.5cm). We supposed hepatic injury suggested toxic hepatitis(induced hepatitis) of herbal medicine. After we administered Saeng gan gunbi-tang for 2days and Alk phosphatase and GGT inadequately was elevated. After that, we stopped administering medicine and the serum transaminase, total bilirubin, serum gamma glutamyl transpeptidase and Alk phosphatase level was decreased. In the abdominal ultrasonogram there was no signal. In the case, we supposed that the changing Sasang constitution and Sasang herbal medicine may induce hepatic injury. We are suggesting the necessity of a test for the hepatic injury of herbal medicine.
선천성 폐 낭성 유선종 기형의 자궁 내 치료 바구니 모양의 도관을 이용한 흉 - 양막강 문합술 2 예
정주연(Joo Yun Chung),원혜성(Hye Sung Won),김소라(So Ra Kim),서미덕(Mi Deok Seo),황보천(Cheon Hwang Bo),김홍권(Hong Kwon Kim),이필량(Pil Ryang Lee),이인식(In Sik Lee),김암(Ahm Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
We report a fetal therapy of two cases of type I congenital cystic adenomatoid malformation(CCAM) of the lung. The two fetuses were treated by thoracoamniotic shunting, using a basket-shaped catheter at 25 weeks' and 31 weeks' gestation, respectively. Cystic lesions of the both fetal lung were successfully decompressed after the shunt operation. Healthy babies were delivered at 41 weeks' and 38 weeks' gestation with normal Apgar score. Surgical resections of the affected lobe of the lung in the both babies were performed without complication at 1st and 7th day of birth, respectively. Shunt operation in-utero is considered as a safe and effective therapy for type I CCAM of the fetal lung.
이원식,박성진,김영경,강성준,조미연,김승민,송창호,정춘희,원영준,이미덕 대한내분비학회 1995 Endocrinology and metabolism Vol.10 No.4
Tuberculosis the thyroid gland occurs only rarely and a few records are available in Korea, despite of high prevalence of tuberculosis. The authors experienced a case of young woman with tuberculosis of the thyroid gland and meninges. Tuberculosis of the thyroid gland was confirmed by demonstration of acid-fast bacilli and granuloma with caseation necrosis on surgical specimen. Description of case profile and a brief review of literature are made(J Kor Soc Endocrinol 10: 434-438, 1995).
이원식,박성진,송창호,정춘희,신영구,원영준,이미덕 대한내분비학회 1995 Endocrinology and metabolism Vol.10 No.4
Periodic paralysis associated with thyrotoxicosis is characterized by intermittent flaccid paralysis of the skeletal muscle. The paralysis usually involve the skeletal muscle of the limbs, especially lower extrimities. In general, sensory function is intact. Involvement of respiratory, ocular or bulbar muscles is very rare, but bulbar and respiratoy invelvement may prove fatal. It is very rare a case that has severe clinical manifestation such as cardiac arrest. We report a case of thyrotoxic hypokalemic periodic paralysis presenting as cardiac arrest(J Kor Soc Endocrinol 10: 428-433, 1995).